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一项在常规临床服务中针对精神病的认知行为疗法的随机对照试验。

A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service.

机构信息

Department of Psychology, Kings College London, Institute of Psychiatry, De Crespigny Park, London, UK.

出版信息

Acta Psychiatr Scand. 2010 Oct;122(4):302-18. doi: 10.1111/j.1600-0447.2010.01572.x. Epub 2010 Jun 28.

Abstract

OBJECTIVE

To evaluate cognitive behaviour therapy for psychosis (CBTp) delivered by non-expert therapists, using CBT relevant measures.

METHOD

Participants (N = 74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered 6 months of therapy and followed up 3 months later. The waiting list group received therapy after waiting 9 months (becoming the delayed therapy group).

RESULTS

Depression improved in the combined therapy group at both the end of therapy and follow-up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two time points (end of therapy: general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow-up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups.

CONCLUSION

The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.

摘要

目的

使用与认知行为疗法(CBT)相关的措施,评估非专业治疗师提供的精神病认知行为疗法(CBTp)。

方法

将 74 名参与者随机分配到即时治疗组或等待名单对照组。治疗组接受 6 个月的治疗,并在 3 个月后进行随访。等待名单组在等待 9 个月后(成为延迟治疗组)接受治疗。

结果

在治疗结束和随访时,联合治疗组的抑郁症状都有所改善。在两个治疗组中的一个组(阳性症状;认知灵活性;思维失控)或两个时间点中的一个点(治疗结束:一般症状、焦虑、自杀意念、社会功能、对声音的抵制;随访:对声音的力量信念、阴性症状)中发现了其他显著的效果。两组之间的成本没有差异。

结论

唯一明显改善的是抑郁症状。尽管如此,除了精神病症状外,在情感和认知变量方面还出现了进一步令人鼓舞但适度的改善。

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